WI VETERANS HOME MOSES HALL

210 CUMBERLIDGE AVE
KING, WI, 54946
7152585586
CCN: 525718
4
Overall
3
Health
5
Staffing
4
Quality
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
OIG Federal Exclusion Matches (1)
This facility's name matches one or more entities on the OIG List of Excluded Individuals/Entities (LEIE). Excluded parties are prohibited from participation in Medicare and Medicaid programs.
CENT WISCONSIN OPTICAL SERV
1128a1
Excluded 1984-02-07
Ownership
NameRole%
STATE OF WISCONSIN5% OR GREATER DIRECT OWNERSHIP INTEREST100%
STATE OF WISCONSINOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
BOND, JAMESOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
BRITZ, BETTEOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
BUTTERFIELD, BRADOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
COONEY, COLTOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
FAY, SUSANOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
FERNANDEZ, GINAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
FLACK, NICOLEOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
KAZA, THANMAYIOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
KIMBALL, POLLYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
MORK, CAITLINOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
PARKER, JAMESOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SCHULZ, JODIEOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SERVATIUS, TAMMYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
STEINGRABER, JONIOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
THIBODEAU, BRIANOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Health Deficiencies (17)
2025-03-19 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
G
F760 · Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
D
F695 · Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
D
F690 · Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
D
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
D
F558 · Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
2024-01-31 · Health
F
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F757 · Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
F656 · Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
2024-01-16 · Health
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
2023-08-01 · Health
D
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
2023-01-05 · Health
D
F657 · Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
F645 · Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
E
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
D
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
F576 · Resident Rights Deficiencies
Ensure residents have reasonable access to and privacy in their use of communication methods.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
4.85
3.68
RN Hrs/Resident/Day
1.02
0.54
LPN Hrs/Resident/Day
0.59
0.81
CNA Hrs/Resident/Day
3.24
2.33
PT Hrs/Resident/Day
0.01
0.12
Data as of 2026-03-01